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Montana rates for HCPCS A5121

Skin barrier; solid, 6 x 6 or equivalent, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.06 / $30.05 / $30.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.17 / $10.17 / $10.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.26 / $10.93 / $10.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.45 / $10.93 / $10.93
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.07 / $10.41 / $10.93
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.36 / $8.21 / $10.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $4.42 / $5.20